Tourette syndrome, a neurological disorder characterized by tics like grimacing, blinking and vocalizations, is normally treated in children and teens with one of several antipsychotic medications. But such drugs usually don't eliminate all the tics, and worse, they can often have side effects, acting as sedatives, causing weight gain and impairing cognitive function.
Now, a multisite study led by a UCLA researcher has developed an effective, non-medication treatment for children and adolescents with Tourette's and related tic disorders that has shown improvement similar to that found in recent anti-tic medication studies.
Lead study author John Piacentini, a UCLA professor of psychiatry and his colleagues at seven sites around the nation found that a specialized form of behavior therapy called comprehensive behavioral intervention for tics, or CBIT, significantly reduced chronic tics and tic-related problems in children and adolescents.
Almost 53 percent of children receiving CBIT were rated as significantly improved, compared with 19 percent of those receiving a comparison treatment, and the degree of improvement with CBIT was similar to that found in recent anti-tic medication studies.
The study appears in the May 19 issue of the Journal of the American Medical Association (JAMA).
Tourette syndrome, which affects approximately six out of every 1,000 children and adolescents, is a chronic neurological disorder characterized by motor and vocal tics, including eye blinking, facial grimacing, head jerking, throat clearing, sniffing and grunting. Although the repetition of curse words is often portrayed as the defining feature of the syndrome, cursing is an uncommon symptom and is not required for diagnosis of the disorder.
"Besides its physical manifestations, Tourette syndrome can cause a number of other problems," Piacentini said. "It is often associated with other psychiatric problems, difficulties in school, work and social functioning, and, in severe cases, can be disabling.
"Historically, Tourette syndrome has been treated with antipsychotic medications, which reduce tics but are associated with side effects that often limit their usefulness in children. So the development of an effective non-medication treatment for children with this disorder is a major therapeutic advance," he said.
CBIT is built on the observation that tics are preceded by unwanted feelings or sensations which in turn are temporarily relieved by the tics. In this treatment, children learned to recognize when a tic was about to occur and to engage in a voluntary action incompatible with the tic until the unwanted sensation passed.
In addition, parents were taught how to promote these management strategies in their children and to minimize stressful situations in their children's environments associated with tic worsening.
In the multisite study, 126 children between the ages of 9 and 17 with moderate to severe Tourette syndrome or Chronic Tic Disorder were randomly assigned to CBIT or to a supportive counseling and education program about Tourette syndrome. Approximately one-third of the children entered the study on a stable dose of anti-tic medication.
The study showed that CBIT resulted in a significantly greater reduction in tic severity and tic-related problems than the supportive counseling. Almost 53 percent of children receiving CBIT were rated as significantly improved, compared with 19 percent of those receiving the comparison treatment.
The degree of improvement with CBIT was similar to that found in recent anti-tic medication studies. Benefits were observed in both children who were on a tic medication and children not on medication. Adverse treatment effects, including tic worsening, were rare in both CBIT and supportive counseling. Treatment gains for CBIT were maintained over time, with 87 percent of available responders showing continued benefits six months after treatment had ended.
"The fact that CBIT works about as well as the standard medications for tics but without the negative side effects greatly expands the available treatment options for chronic tic disorders," said Susanna Chang, a UCLA assistant professor of psychiatry and a study author. "Importantly, CBIT also emphasizes the development of skills that foster autonomy and empowerment, allowing for patients and their families to take a more active role in treatment than previously indicated."
Piacentini noted that additional studies are underway using neuroimaging and other neuroscientific techniques to examine the brain mechanisms underlying how CBIT might work. In addition, investigators are currently working with the Tourette Syndrome Association and the U.S. Centers for Disease Control and Prevention to teach CBIT to clinicians who treat children with tic disorders and to develop new versions of CBIT for use with younger children and by nurses and other health care professionals.
Other authors on the study included Douglas Woods, of the University of Wisconsin–Milwaukee; Lawrence Scahill and James Dziura, of Yale University; Sabine Wilhelm and Thilo Deckersbach, of Massachusetts General Hospital/Harvard Medical School; Alan Peterson, of the University of Texas Health Science Center; Dr. John Walkup and Golda Ginsburg, of the Johns Hopkins Medical Institutions and Weil–Cornell Medical School; and Sue Levi-Pearl, of the Tourette Syndrome Association.
The study was funded by the National Institutes of Health. The authors report no conflict of interest.
The UCLA Department of Psychiatry and Biobehavioral Sciences is the home within the David Geffen School of Medicine at UCLA for faculty who are experts in the origins and treatment of disorders of complex human behavior. The department is part of the Semel Institute for Neuroscience and Human Behavior at UCLA, a world-leading interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.
For more news, visit the UCLA Newsroom and follow us on Twitter.
Mark Wheeler | EurekAlert!
Physics of bubbles could explain language patterns
25.07.2017 | University of Portsmouth
Obstructing the ‘inner eye’
07.07.2017 | Friedrich-Schiller-Universität Jena
Physicists working with researcher Oriol Romero-Isart devised a new simple scheme to theoretically generate arbitrarily short and focused electromagnetic fields. This new tool could be used for precise sensing and in microscopy.
Microwaves, heat radiation, light and X-radiation are examples for electromagnetic waves. Many applications require to focus the electromagnetic fields to...
Strong light-matter coupling in these semiconducting tubes may hold the key to electrically pumped lasers
Light-matter quasi-particles can be generated electrically in semiconducting carbon nanotubes. Material scientists and physicists from Heidelberg University...
Fraunhofer IPA has developed a proximity sensor made from silicone and carbon nanotubes (CNT) which detects objects and determines their position. The materials and printing process used mean that the sensor is extremely flexible, economical and can be used for large surfaces. Industry and research partners can use and further develop this innovation straight away.
At first glance, the proximity sensor appears to be nothing special: a thin, elastic layer of silicone onto which black square surfaces are printed, but these...
3-D shape acquisition using water displacement as the shape sensor for the reconstruction of complex objects
A global team of computer scientists and engineers have developed an innovative technique that more completely reconstructs challenging 3D objects. An ancient...
Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.
For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...
26.07.2017 | Event News
21.07.2017 | Event News
19.07.2017 | Event News
27.07.2017 | Life Sciences
27.07.2017 | Life Sciences
27.07.2017 | Health and Medicine